Bill To:

DAIRYLAND INSURANCE
1800 NORTH POINT DRIVE
STEVENS POINT, WI 54481-1253

Services Rendered To:

Rios Francisco
116 Quail Ridge Dr
Dale, TX 78616
POLICY# 11408621423


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

    4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: RM 620 & Pearson Ranch- Austin, TX

Subtotal $600.00
Total Due $600.00


Checks Payable To:

Sure Fire Recovery Service, LLC
9711 S Mason Road 125-120
Richmond, TX 77407
Federal Tax ID – 83-4417185


  Please Include Incident Number On All Correspondence.
Updated
May 23, 2023 @ 12:21 pm

Invoice updated by Geoffrey.

Status Update
May 23, 2023 @ 12:21 pm

Status changed: Draft to Pending.